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*Zhenjing Zhinan* (Guidelines for the Needle Classic), written by Dou Hanqing.

Among methods to save lives, the subtle application of acupuncture is most wonderful. Observe the heavenly way to understand seasonal changes, and determine the patient's constitution within your own mind. In spring and summer, when the body is lean, needling should be shallow; in autumn and winter, when the body is robust, needling should be deep.

If one does not exhaustively explore the yin and yang of the meridians, one will often encounter contraindications for needling; since the deficiency and excess of the zang-fu organs have been discussed, one must seek points along the meridians.

Tracing back to the origin, it starts from the Middle Jiao (Middle Burner), where water and grain first enter. The Hand-Taiyin Lung Meridian begins, ending with the Foot-Jueyin Liver Meridian. Points start from Yunmen (LU-1) and end at Qimen (LR-14). There are twelve regular meridians and over three hundred branch collaterals; in various postures (upright, supine, prone), there are over six hundred qi observation sites. The Hand and Foot Three-Yang meridians: hand goes to head, head goes to foot; the Hand and Foot Three-Yin meridians: foot is on the abdomen, chest goes to hand. To understand Ying-Sui (following and opposing) techniques, one must clearly know reverse and forward directions. Moreover, the variation in the amount of qi and blood among yin and yang is paramount. Jueyin and Taiyang have little qi and much blood; Taiyin and Shaoyin have little blood and much qi. Furthermore, Shaoyang has much qi and little blood, while Yangming has both abundant qi and blood. First, carefully consider the appropriateness based on abundance or scarcity; second, observe the arriving qi. Light, slippery, and slow indicates qi has not yet arrived; heavy, choppy, and tight indicates qi has arrived. Once arrived, retain the needle according to cold or heat pathogens; if not arrived, induce qi based on deficiency or excess. When qi arrives, it feels like a fish swallowing bait, rising and sinking; when qi has not arrived, it feels like sitting in a deep, quiet hall. Fast arrival of qi brings fast results; slow arrival makes treatment difficult.

Observing the method of the Nine Needles, subtlety lies in millimeters. The Seven Stars (seven types of needles) correspond to the Five Elements, governing numerous acupoints. The needle's form is Metal, possessing the way to dispel evil and support righteousness; its length is Water, having the mechanism to resolve stagnation and open blockages; its insertion depth is Wood, either expelling evil or supporting righteousness; holding the handle warms Fire, advancing yang and tonifying weakness; following mechanisms and covering pores resembles Earth, reflecting the Five Elements. However, this one cun and six fen contains profound principles; though fine as hair, it connects diverse paths. It can balance cold and heat of the Five Zang organs and regulate deficiency and excess of the Six Fu organs. For spasms and blockage, pursue the Eight Evils to remove them; for cold, heat, pain, and bi syndrome, opening the Four Passes can cure it.

Before needling, ensure the patient's Shen (Spirit) is focused before insertion; after needling, ensure the Shen is calm so qi follows. Do not needle if Shen is unfocused; proceed if Shen is settled. Where to fix the needle, focus on regulating blood and qi; where to insert, recognize water and fire as the foundation. Heaven, Earth, and Man (Three Talents): Yongquan (KI-1) corresponds to Xuanji (CV-15) and Baihui (GV-20); Upper, Middle, and Lower parts: Dabao (SP-21) connects with Tianshu (ST-25) and Diji (SP-8). Yang Qiao, Yang Wei, and Du Mai govern exterior diseases of shoulder, back, waist, and legs; Yin Qiao, Yin Wei, Ren, Chong, and Dai Mai address interior doubts of heart, abdomen, flanks, and ribs. Er Ling (Yanglingquan GB-34, Yinlingquan SP-9), Er Qiao (Zhaohai KI-6, Shenmai BL-62), Er Zhi (Waiguan TE-5, Neiguan PC-6) seem continuous and intersect with Wu Tai (Taiyuan LU-9, Taibai SP-3, Taichong LR-3, Taixi KI-3, Hegu LI-4); Liang Jian (Erjian LI-2, Sanjian LI-3), Liang Shang (Shangyang LI-1, Zhongzhu TE-3?), Liang Jing (Yinbai SP-1, Dadun LR-1), rely on each other and list two branches. Methods for selecting points require understanding proportions. First examine your own intent, then observe muscle layers. Obtain points through flexion/extension or stabilize them in straight positions. On the yang side near bones/tendons, depressions are true points; on the yin side..., arterial pulses correspond. To take five points, use one point as the standard to ensure accuracy; to take three meridians, use one meridian as the standard to ensure correctness. Head and shoulders are detailed separately; Du and Ren meridians are easy to locate. Examine Biao (Branch) and Ben (Root) to discuss deep/shallow needling meridians; to move pain, select intersecting/penetrating pathways.

Did you not hear that for zang-fu diseases, seek the subtle meanings of Mu (Alarm) and Shu (Transport) points; for meridian stagnation, seek Yuan (Source), Luo (Connecting), and intersection points. Further investigate Si Gen (Four Roots) and San Jie (Three Knots), needling according to Biao/Ben ensures recovery; using Ba Fa (Eight Methods) and Wu Men (Five Gates), distinguishing host/guest ensures efficacy. The Eight Extraordinary Vessels connect to the Eight Hui (Influential) points, forming the outline; the Twelve Regular Meridians have their Twelve Yuan Source points, serving as pivots. Using sixty-six points daily reveals subtleties; using the Twelve Yuan points of the meridians hourly reveals essentials.

Originally, tonification and sedation depend not on respiration but on finger manipulation; rapid effects require correct positioning and identifying the affected meridian. Jiao Jing (Crossing Meridians) and Miao Ci (Mysterious Puncture): disease on the left is treated on the right; Xie Luo (Draining Collaterals) and Yuan Dao (Distant Guidance): disease on the head is treated on the feet. Ju Ci (Great Puncture) differs from Miao Ci; Micro-needles connect with Mysterious Puncture. Observing regions knows meridian deficiency/excess; viewing pulse floating/sinking sees organ cold/warmth.

First, ensure needles are bright and undamaged; next, warm the needle mouth in the mouth to heat the needle. Do not look outward; hold hands like grasping a tiger. Heart free from distraction, treat like a noble guest. Left hand presses heavily and rubs often to disperse qi; right hand inserts lightly and slowly to avoid pain. Fear of empty stomach: standing causes dizziness, lying on side is better; back eyes, press deeply, sit/lie flat to avoid fainting. Push through Ten Stems and Ten Changes to know point opening/closing; discuss Five Elements and Five Zang to observe time旺衰 (prosperity/decline). Lie like a drawn crossbow, respond like releasing the trigger. Yinjiao and Yangbie settle blood vertigo; Yinqiao and Yinwei deliver placenta. Bi, jue, hemiplegia: Ying-Sui reconnects meridians; Lou, beng, leukorrhea: Warm Tonification returns qi/blood. Retain quietly for long periods, wait for needle. Precise location: Zhaohai treats throat obstruction; Exact location: Dazhong treats mental dullness. Generally, pain uses Sedation for excess, tonification for deficiency in itching/numbness. Weighted joints/pain governed by Shu points; epigastric fullness governed by Jing points. Heart distension/throat pain: needle Taichung to remove; Spleen cold/stomach pain: drain Gongsun to cure. Chest fullness/abdominal pain: needle Neiguan; Flank pain/distension: needle Feihu. Spasm/bone pain: tonify Hunmen; Body heat/labored cough: drain Pohu. Head wind/headache: needle Shenmai and Jinmen; Itchy/painful eyes: drain Guangming and Diwu. Drain Yinxi to stop night sweats, treat pediatric bone-steaming fever; needle Pianli to promote urination, treat adult ascites. Stroke: Huantiao suitable for needling; Deficiency: Tianshu selectable.

Thus, before noon (Mao hour), Taiyin generates and warms quickly; Li (South) left, You (West) south, moon new dies and cools quickly. Rub/pluck/stretch, retain inhale mother for firm/long; claw/stretch/lift, quick exhale son for short. Move/retract/empty/rest, welcome/drain right for cooling sedation; push/insert/rub/follow/nourish left for warming tonification. Generally, critical cases with mismatched color/pulse: do not needle; cold, heat, wind, yin days: strictly avoid. Full moon day no tonification, last day no sedation; waxing moon no draining, new moon no nourishing. Refine heart and exhaust methods, do not let moxa ruin the middle; correct principle and seek origin, avoid missing point position. Avoidance for moxibustion: forty-seven points on limbs and torso; Contraindicated for needling: twenty-two points excluding the Six Shu.

Once heard: Emperor Gaozu was ill and unhealed, Li Shi needled Juque (CV-14) and he revived; Crown Prince suddenly died of Jue, Yue Ren (Bian Que) needled Huihui (likely referring to specific points or technique) and he woke up. Jianjing (GB-21) and Quchi (LI-11): Zhen Quan needled arm pain and it immediately shot away; Xuanzhong (GB-39) and Huantiao (GB-30): Hua Tuo needled foot and he walked immediately. Qiufu needled Yaoshu (GV-2) and soul avoided sinking; Wang Zuan needled Jiaoshu and demons exited immediately. Take Ganshu (BL-18) and Mingmen (GV-4), make blind see autumn down; Shaoyang and Jiaobie, make deaf hear summer mosquitoes. Alas! As we go further from the Sages, this path declines. Some lose interest and scatter their learning; some rely on luck and violate contraindications. Mediocre and ignorant, hard to match the profound subtleties; the Great Way is deep. How many attain it?